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【目的】了解肝细胞癌(HCC)在低场MRI上的边缘形态及其病理基础。【方法】分析33例手术病理证实的肝细胞癌在术前MRI的边缘形态并对24例标本MRI与病理基础对照研究。【结果】①33例HCC术前MRI的132个边缘方位在T2WI上分为3种:边缘清楚无分叶82个(621%)、边缘清楚伴分叶20个(152%)、边缘不清30个(227%);②HCC边缘形态在术后标本MRI扫描与术前MRI扫描的相同率为792%;③24个标本MRI扫描与病理对照:MRI上肿瘤边缘清楚无分叶的以完整包膜为主,占882%、肿瘤边缘清楚伴分叶以包膜不完整或多结节状改变为主,占675%、肿瘤边缘不清则以无包膜多见,占667%。肿瘤边缘清楚无分叶的85个方位点中病理上癌旁周围肝组织发现癌细胞的有12个方位点(占141%),而边缘清楚伴分叶的40个方位点及边缘不清的45个方位点癌旁发现癌细胞的百分率则分别为425%及556%。【结论】HCC在低场MRI的T2WI上的边缘形态分类能够很好地反映病理上肿瘤包膜的完整程度及肿瘤向周围肝组织浸润生长情况,对癌细胞分级的评价有一定帮助
【Objective】 To understand the marginal morphology and pathology of hepatocellular carcinoma (HCC) in low-field MRI. 【Method】 The margins of preoperative MRI in 33 cases of hepatocellular carcinoma confirmed by surgery and pathology were analyzed. MRI and pathology of 24 cases were compared. 【Results】 ① The 132 limbal locations of 33 HCC preoperative MRI were divided into three types on T2WI: 82 (621%) with no edge, 20 (152%) with clear edge and 30 (227%). ② The same rate of edge scan of HCC was 792% compared with that of preoperative MRI scan. (3) The MRI scan of 24 specimens was compared with the pathological examination: The main tumor accounted for 882%. The tumor margins were clearly associated with incomplete or multiple capsule nodules, accounting for 675%. The unclear tumor margin was found to be non-enveloped, accounting for 667%. There were 12 sites (141%) of cancer cells found in pathologically paracancerous adjacent tissues in 85 sites with clear lobes and 40 marginally clear edge The percentages of cancer cells found beside 45 cancer sites were 425% and 556% respectively. 【Conclusion】 The edge morphological classification of HCC on T2WI in low-field MRI can well reflect the completeness of pathological tumor capsule and the infiltration of tumor into surrounding liver tissue, which will help to evaluate the grading of cancer cells